Bourke Street Accused Gargasoulas Returns To Melbourne Court

A Melbourne psychiatrist says the man accused of killing six pedestrians in the city's Bourke Street suffers "bizarre" delusions that would affect his ability to enter a plea.

Associate Professor Andrew Carroll, who assessed James "Dimitrious" Gargasoulas fitness to stand trial, will continue giving evidence in a Supreme Court of Victoria hearing on Wednesday.

Gargasoulas, who suffers treatment-resistant paranoid schizophrenia, allegedly mowed down pedestrians in January 2017, killing six and injuring dozens more.

Assoc Prof Carroll says Gargasoulas understands his different legal options and the court process, but said his delusions would affect what plea he decided to enter.

Gargasoulas is said to suffer delusions including that he is the Messiah, he killed the pedestrians under divine instruction, a comet will hit the earth, and that he has been born seven times before.

"From Mr Gargasoulas' perspective, these are not beliefs, this is knowledge. He knows he is the Messiah; he knows there is a comet coming," Prof Carroll said on Tuesday.

Gargasoulas' legal team is arguing he is not fit to stand trial as he can't "meaningfully" enter a plea, cannot understand the substantial effect of evidence or instruct his lawyer.

But crown prosecutor Kerri Judd QC argues Gargasoulas is capable of rational thought and is making a bid to be held at Thomas Embling psychiatric hospital rather than in jail so he might eventually be "released into the community".